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HomeMy WebLinkAbout0076 VANDERMINT LANE - Health 76 Vandermint Lane Hyannis A =250 - 056 1 � i , r> TOWN OF BARNSTABLE LOCATION � ./' / �20 SEWAGE:# .. VILLAGE �� e�`�c3. ASSESSOR'S MAP&:LOT f INSTALLER'S NAME&PHONE NO.��LGi wS i -. SP® 7 7 J)3 C:�- SEPTIC TANK_CAPACITY - - • -. ® __ LEACHING F `&rrY: (ty �JaS o.1,��� T 2.9rD_ ,. `. .'NO.OF BEDROOMS_ { BUILDER OR OWNER Z /� BUILDER PERMITDATE: 3 ° COMPLIANCE DATE v^ Separation Distance Between-the: Maximum Adjusted Groundwaterable to the Bottoin.of Leaching Facility-. Feet. Private Water Supply Well and'Leaching Facility (Yany..wells exist on site or within 200 feet of leaching facility) t. r Edge.of Wetland'and Leaching Facility(If any wetlands exist within 300 k6- f leaching.facility) Feet Furnished by �.J W o C vy t 10 -0 Off No. f O Fee HE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplit tion for Misposal fps m Construrtion Permit Application for a Permit to Construct( Repair( ) Upgrade( Abandon( ) ❑Complete System ❑Individual Components Locatio. ddre o Lot No w�v �3 O er's Name,Address, Tel.No. 7's �.✓��'`�l Assessor's Map/Pazc 1 �. �• Ins ]ler's Name Address and Tel.No. Designer's Name,Address,and Ted.No. ",P ->75-i3 ?E S76F 5-3 come, Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder, Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) G/ O gpd Design flow provided ��i gpd Plan Date �/ v�d Number of sheets Revision Date -T Title Size of Septic Tank / l7 ?' Type of S.A.S. -3 0 57 4.4 f G►'Zr Description of Soil Nature of Repairs or Alterations(Answer when applicat e) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by-this Board c ealth. Date 3 O Application Approved by Date 11/2 Application Disapproved by Date for the following reasons Permit No. Date Issued j { D�� a yH.No./: s �a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS' Yes 01ppliration for Disposal ��Abandnript Construction Permit Application for a Permit to Construct Repair Upgrade El Complete System ❑Individual Components Location ddress or Lot No " /l/X oq n//v f-S Owner's Name,Address,a Tel.No. 7 6 �.✓Q���I ! '. ._ Assessor's Map/Parcel In , ller's Name Address and Tel.No. Designer's Name,Address,and Tel.No. T-i3 77 F_�'6 G4��r�/ S`vi 5:3 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grmder,(12�-� Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures / J Design Flow(min.required) e-1 el, O gpd Design flow provided y6 l . 7 6 gpd Plan. Date f y��(7116) Number of sheets Revision Date r Title Size of Septic Tank / j O Type of S.A.S. 7 aj A f d zjr Description of Soil r Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: 1 The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued b this Board o£Health. ig ._ __ Date It Application Approved by Date Application Disapproved by Date for the following reasons n Permit No. �-- Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded Abandoned( )bye AGL at �,i 4/ ,.rC OL T has been constructed in accordance with the provLisions of Title 5 and the for Disposal System Construction Permit No. 2 0 t Q-U_S7 dated / Installer Designer C-�9/I VA gni Y #bedrooms e7l Approved design flov(G1 y �n gpd The issuance of tjis pe it shall not be construed as a guarantee that the system, ill , cion as design . Date 1 1 J Inspector No. -----= ---------- -----_-------------------------------------I------- -------------------------01 0 7 7 0—6- Fee----- -y ---- ---_. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Disposal �pstpm Construction �Prmit Permission is hereby granted to Construct( ) Repair( ) Upgr e( Abandon System located at �i' �-ca�E 2 o z, ^i r 6Z 7 ,19 ,6' -F !i = r and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be c7m, leed within three years of the date of this permit. Date I / Approved by ' TRANS. NO.: # Z ; CITY/TOWN: ��Z� APPLICANT: ADDRESS: DESIGN FLOW: 4AU gpd REVIEWED BY: DATE: N/A OK NO GENE Legal boundaries denoted [310 CMR 15.220(4)(a)] Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided [310 CMR 15.2204(t)] Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] V, Easements shown [310 CMR 15.220(4)(b)] System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] Location of impervious surfaces (driveways, parking areas etc.) [310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR 15.220(4)(c)] Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] System Calculations [310 CMR 15.220(4)(f)] daily flow septic tank capacity (required and provided) soil absorption system (required and provided) whether system designed for garbage grinder North arrow [310 CMR 15.220(4)(g)] Existing and proposed contours [310 CMR 15.220(4)(g)] i/ Location and log of deep observation holes (existing grade el: on each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR ✓ 15.220(4)(h) and (0] Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(1)] Percolation test results match loading rate? [310 CMR 15.242] Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] Observed and Adjusted groundwater (method for adjustment _ given or indicated) [310 CMR 15.103(3) and 310 CMR ' 15.220(4)(n)] Address Lev, AdNss;:,�5 Sheet 1 of 7 N/A OK NO Location of every water supply, public and private, [310 CMR 15.220(4)(k)] within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case i✓` within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. [310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located [310 CMR 15.220(4)(m)] (if water line cross see 310 CMR 15..21l(1)[11) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor (required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] Test hole adeq-fate to demonstrate four feet of suitable material? [310 CMR 15.103(4)] Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benclunark within 50-75' of system [310.CMR 15.220(4)(q)] Materials specifications noted? [various sections of 310 CMR 15.000] System components not > 36" deep (unles Local Upgrade; Appr LUA requeste [310 CMR 15. Addresst�N Sheet 2 of 7 f N/A OK NO Size OK?�[310 CMR 15.223(1)] Inlet tee located ten inches below flow line [310 CMR 15.227(6)] Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR 15228(1)] Separation between inlet and outlet tees (no less than liquid depth) [310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for V upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 0� CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] Access to within 6 " of grade - one port for systems<1000gpd, two for systems >1000 gpd [310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [31.0 CM � 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Buoyancy calculation Required/Done [310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.211] Required when other than single-family dwelling or flow>1000 ✓, gpd [310 CMR 15.223(1)(b)] First compartment 200% daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and (3)] "U" pipe through or over baffle, outlet of each-compartment with gas baffle or approved filter [310 CMR 15.224(4)] Address � � ��1�i�csei a -A�� ` ��N�� , �'��� Sheer of N/A OK NO ILA' S® 2P1IONSYSTEMS,(SAS� GENEIt�A � 2 3 Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] Required separation to groundwater? [310 CMR 15.212)] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.2411 Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] G' °lRIES;PINS,CIIAMgBERS31QC R 15253 .. . >M .. .....,.: Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] y Each structure with one inspection manhole (if>2000 gpd must be to grade) [310 CMR 15.253(2)] Aggregate I' minimum- 4' maximum. [310 CMR 15.253(1)(b)] 2' sidewall credit maximum [310 CMR 15.253(1)(a)] In bed configuration, inlet every 40 sq. ft. [310 CMR 1.5.253(6)] Width 2' minimum 3' maximum [310 CMR 15.251(1)(b)] 100 feet -maximum length [310 CMR 15.251(1)(a)] Minimum separation 2x effective depth or width whichever ✓ greater (3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(1)[41 and Guidance Document] minimum 2 distribution lines [310 CMR 15.252(2)(a)] Maximum separation between lines 6' [310 CM R15.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6" minimum, 12" maximum. [310 CMR 15.252(2)(g)] Separation between beds IU minimum. [310 CMR 15.252(2)(0] Bottom area used in calculations only [310 CMR 15.252(2)(1)] 9/ Address. >(A LA-3t, � k�-�. 7:o�._5 Sheet 5 of 7 U 6 N/A OK NO �, d .. g-k a .B - ° , DZD THE PLAI ::INO�YE � M3 i »h?�n< �..," Pressure Dosed System ? Provided pump and piping calculations as required [310 CMR 15.220(4)(r)] Pressure dosing required on all systems >2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] If used in gravelless system - make sure jet is directed as not to scour soil interface [Guidance Document] Inspections once per year (systems< 2000 gpd) or quarterly (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] Construction in fill - Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? Impervious barrier and/or retaining wall ? [Guidance Document] Iinpeivious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2) and L/ Guidance Document] At least. 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] Gra"vellessSystnl �I/A Ap,,Provc�lLeftersJ, :` � _ kw 4 rr Check DEP Approval letters for credits and design conditions V,_ If used with pressure dosing do not allow pressure discharge to scour soil interface � a �''�' � '€6 y v � t r�q v�. y "�v<a:� kv a .k � `��, •. yr V� K � 1� F€ � k 'f -a. � Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all v DEP Approval Conditions? Is there a note on the plan regarding the requirement for v perpetual maintenance agreement? Any alarms involved on separate circuits di- Did the applicant submit an operation and maintenance manual? Has applicant submitted a copy of a maintenance Y111M1C111CeS 1 _Are the variances listed on the plan ? [310 CMR 15.220 (4)(q)] RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed - [Refer to 310 CMR 15.414] Address , �G\1C'� .��+��s�� � � ��eJ�rQt-1i 5 Sheet 6 of 7 N/A OK NO IVLtYO�G'IZ SGilSltll�6 fjl BEZS s > s "4 ., xMm_�w�,,. .,�w,.�,.�..'�`_ax„�,z. ?�,a�,�,»�_ �w°i`,�.a�4 Is the system in a Designated Nitrogen Sensitive Are (Zone II for a public supply well)? [310 CMR 15.214, 310 CMR-15.2 and / 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? [310 CMR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] Pumping to septic tank ? [ 310 CMR 15.229] Shared System [310 CMR 15.290] Address L--3`A�� nL� Sheet 7 of 7 Town of Barnstable °Ft"E r Regulatory Services Thomas F. Geiler, Director + BARNSTABLE, v� Ib39 Public Health Division ArEO ,�p Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 3� p Designer: Shay Environmental Services, Inc. Installer: -Ci ,� L� Address: P.O. Box 627 Address: East Falmouth, MA 02536 _ L � t On —HLC�4� �Cg�CV� was issued a permit to install a (' ate) (installer) septic system at V ao 8R�2 i fA based on a design drawn by (address) Shay Environmental Services, Inc. r dated ("A) f I I D (designer) I certify that the septic system'referenced above was.installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. I -�t10F MgsS CARVEN (Installer's Signature) '` E. U : SHAY P No. 1181 GasTEt� S FN qt`i ( esigner's Signature) (Affix Desi p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form LdCATION SEWAGE PERMIT NO. 7 -76 VILLAGES A & B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIA?vCE ISSUED is t S t Cs 1 � o i r � I� r No.8 ...... . THE COMMONWEALTH* OFMASS/�ACHUSEETTS BARD :OF HEALTH .......................T aa-n-------.0 F.........Barns tabie-.................................................... Appliration for UiipnsFal Worko Tonotrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at: 76..Vande ........................•• .... .............. .......•••--•-..........-- Location-Address or.Lot No. John Raffael ... - 11 Park Drive, )tjt3 Boston=-�-•-02215 _. Owner Address A & B Cesspool Service, Inc . 128 Bishops Terrace, Hyannis, PfA 02601 ......-••-••••.....---- Installer Address Type of Building Size Lot----------------------------Sq. feet U a Dwelling—No. of Bedrooms...............3..........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons------------4............. Showers ( ) — Cafeteria ( ) Other fixtures -----------•---------------------------- ----------------------- W Design Flow............................................gallons per person per day. Total daily flow_._................._.........._............gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total,leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ W Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f%4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 .....---•--------------•-----------•--......---...------------............----------••......--------......................................................... 0 Description of Soil------.Salld....................................................................................................................................................... •--••--•--•--•------------•----•-•-•......---•---------------•-----------•.....•-••------------•----------••---•--••----------•----•--•-••--•-------...-•-----------------------•--••..... W UNature of Repairs or Alterations—Answer when applicable_ nstal lati on of a 1,000 gallons pre-cast, stone packed leach pit ------------------------------••----------------------------------------•--------•-•••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLI 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ben issued by th e 'oard h lth Sig e ' . P 5/31/85 ...... --------------------•-- Date ApplicationApproved By---------- ---- -•-- ---------..:......---------......---------•-•-----•------.........•-- ......5.hiA5................. Date Application Disapproved for th f llowin easons:---••-----••---•---------•--•---••-•----•---------••---•---------•-•..__---•-= ...................................................... -----•---.........-----------....-------•--•------------------•-----••-•---•--•-•--------•------------•---•------------------•-----...------ Permit No.-----85--•....•-'-a-- ----•--•-•••.... 5/ 1 85 �. .... Issued._.. •......•.•.Date...... Date I� No 8.5'.....---_....... Fx$....$...1.5..00..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................Twn........OF........8A able.... Appliration for Disposal Works Tons rnrtinn rranit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 76 Vandermint Lan...e...Hyan??i s�- A 0260. ........... .................................................................................................. Location-Address or"fit No. John Raffael it Park Drive, Apt 1 Boston.....................A 015 ---••----------------------.....----.....--•--------.....------------------------... ........ •-- Owner Address a A & B Cesspool Service, Inc. 128 Bishops Terrace, Hyannis, MA 02601 -- . -...----- Installer Address Type of Building Size Lot........ ......... ....Sq. feet U Dwelling—No. of Bedrooms...............3......_....._.....__......Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons a Other—Type g -•---•-••------•----------•• P 4-------------- Showers ( ) — Cafeteria Otherfixtures .----•------------------•------•---•------•------------•--•-•------•-•----•-••......-----------..................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width............_....... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a+' --••-•-------•-•••-----•----•-•-----•--•-------------•-••-•----------••--•------•---.............---......................................................... 0 Description of Soil.......g4T ..........•... x U --•-----------------------------•--------•--•--•---••---•-•-••-----•-•-------------•-...--••---•••.....•--•--•---------......-------•--•-•----•----------------•--•-------•-•----•-----•---•----------- w x ............................... -•--------•----••••••••••--•--•••---•-----------•-•--•-•-------------------•-••------------•-•-•••-•--•-----------•-•-------------••-----•......--------•-----------•-•- U Nature of Repairs or Alterations—Answer when applicable installation of a .1,000 gallon, pre-cast, stone packed leach pit (overflow . --•-----------------------••--•-••--------------------------------•-----------------•--------------•-------.....----•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the�board,,Qalth. Signed_.. C -rr..C-� _. :----- --- 5/31/85 Date Application Approved By................................---•.....................•-----....------------......-----•-----• 51.311_85 Date Application Disapproved for the following reasons------------------------------------------•------------------------------------------•--•- ......-----•---..... -•--•-•--•-----------•----••-----------------•-••--•-•------......_.....-------•--....---------..... Date `I Permit No...... 5. ............................................ Issued.-----•----------•-• /3 / 5 85 5 -�-8•- ,u Date THE COMMONWEALTH OF MASSACHUSETTS \ *` BOARD OF HEALTH .......................Town........OF...........�amstable ................................................... Trr$ifiratr of TuanpliFanrr _ THIS IS TO CERTIFY, That the Ind; id 1 Sewae Disposal System constructed ( ) r epaired ( X) by A & B Cesspool Service, Inc. Y�8 Bishops -Terrace, Hyannis, T" 060 - ----------------------------------------------------------------------------------------------------------------------------------------- at.._..76 Vandermint Lane, Hyannis, A?A 026ftta❑er John Raffael • • -•••-----. .................. ..•- ------ has been installed in accordance with the provisions of . -•--__. dated----------------------- IF 5 of The State Sanitary Code ��l�s ed in the application for Disposal Works Construction Permit No..... ............._..__......_ 3 //O° ................. THE �.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO;SETTS ® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. r� 5/31/85 r� DATE........................ ..•----------- ................ Inspector....:... ..-•----�111­1'1 __........ �I THE COMMONWEALTH OF MASSAC BOARD OF HEALTH Town Barnstable 1 85 5?,-- ..........:................................OF...........................••..........••... $ 15.00 FEE........................ Disposal Works Tnntrnrtinn frrmit Permission is hereby granted........A & B Cesspool Service, InC. to Constryct ( ) or,Repair (X ) an Individual Se Disposal System at No...7....Varriermint Lane, Hyanniiss, MA `� 01 - John Raffael •----------------------•-•-----•------------------------------•---•-....--------------------------------------------------------------------------------•---•-------- Street as shown on the application for Disposal Works Construction Permit No 85 ...__..___. Dated.._......_5/31/85 5/31/85 B r of a DATE................................................................................ FORM 1255 A. M. SULKIN. INC., BOSTON ;q Town of Barnstable P# Department of Regulatory Services - ' Public Health Division Date v` = twentarns�, 161 wK���s� 200 Main Street,Hyannis MA 02601 Date Scheduled I Time Fee.Pd. ° So' uitability Assessment for Sewage Disposal Performed By: tA'(�N► A?a Witnessed By: �t w LOCATION& GENERAL INFORMATION _ Location Address Owner's Name ' '. — —�:vsx >• _ „� C�11� M Address Assessor's Map/Parcel: SQ —� Y �v Engineer's Name NEW CONSTRUCTION REPAIR -Telephone# CA— Land Use. 7�z� N3 QV Slopes(�o) � L,a Surface Stones Distances from: Open Water Body r`�31�Q ft Possible Wet Area�ft Drinking Water Well ��ft Drain e Wa ft Pro eI. Line P g y— — P ,y ft Other SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ' I . . ova, _ r co �l l Parent material(geologic)_ y Depth to.Bedrock �. Depth to Groundwater. Standing Water in Hole:�1�6tti �`bS`�•' t Weeping from Pit Face 1�1 O 1D5 LJ ear I Estimated SHigh easonal Hi h Groundwaf r its g e � I DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used:.' Depth Observed standing in obs.hole: _ __ id, Depth to loll mottles: Depth to weeping from side of obs.hole: , —_ In. Groundwater Adjustment ft. =Index Well# Reading Date: Index Well level— Adi,factor _ Adj.Croundwater Level PERCOLATION TEST lute� Time Observationt Hole# Time at 9" Depth of Perc _ Time at 6 =-d(� Start Pre-soak Time @ h',©b - 'rime(9"-6") rh End'Pre-soak. b ',O(2',b Rate Min./Inch �.'►.� Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) k. . Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICVERCFORM.DOC F, DEEP.OBSERVATION HOLE LOG Hole# I Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. consistency,%Gravel) to Yp- �15Y DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ^p Consistency.% pie DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi e ° I Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No,--L,—1 Yes Depth of Naturally occurring Pervious Material Does at least four feet of naturally occurring pervious atonal exist in all areas observed throughout the area proposed for the soil absorption system? Q S If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date have passed the soil evaluator examination approved by the Department of Environ 1 Pr n n at the above analysis was performed by me consistent with jl the required training,a erhse nd ex r' ce escribed in 310 CMR 15.017. Signature Date I Q:�SEPTIC�PERCFORM.DOC 3" of 1/8" - 1/2' Washed Peostone *NOTE: ALL PIPES ARE TO BE 4' SCHEDULE 40 P.V.C. VENT PIPE (0Least 24 inches tall) _ i , 10' min. from Schedule 4o PVC w/Charcool odor Filter 3/4" to 1 1/2 " DOUBLE Washed Crushed Sto ��` ! 1tj :*41 3 �. �s } t V1 Existing Foundation house to septic tank •�� /-.,� s TOP OF FOUNDATION ELEV. 100.00 (Assumed) �a tank aava must be D-BOx cover must be wRhtn a In. of finished grade wkhin a• of Grose 4" PVC (CAPPED) INSPECTION PORT TO BE over Septic Tank -9a.50 3 HOLE H-10 Oro"over D-Ow-WOO ever SAS-Ye.00 INSTALLED AND TO BE WITHIN 6" OF GRADE 4/ f, w. •. ' ' f DIST. �� li•'.''h i1r r ?�'�� ,�� i �1 •��.i• 3' Nmdmum Cover 'R 16' NEW 5.0.01 a Greater Tao�s>At�-Ow. .ga.00 � %� , ; Ex1sT. t•tn� 1.500 GAL 13. S. 0.01• lI • rt s`•:may s f FROM EIGST• roumATEN m SEPTIC TANK g per foot 1 24 Effectiv { ' •+ o, 1 CONCRETE Ir= rouNOA n � H-10 ei _�Sidewat � � ��,,.�IE „� 2' EFFECTIVE DEPTH 4 Units @ 7' =28' J 'I cr SCOL r �( u Ti > �i B' �t I SYSTEM PROFILE o 4' •--� 4' ° Effective Len 4 Not to gth Tji Not to Scale i c 2' N 9 $ EFPective Vrwtt, 36' NOTE: SEPTIC TANK do D-Box TO BE CONSTRUCTED ON LEVEL COMPACTED BASEI a In.of 3/4--1 1/V g ay° SECTION A -A GENERAL NOTESco - NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6' BELOW GRADE 'Pa`t'd stone PROFILE VIEW OF LEACHING SYSTEM 1. Contractor is responsible for Digeofe notification, Verification of Utilities 0 0 p m SOIL ABSORPTION SYSTEM SAS and protection of all underground utilities and pipes. (SAS) 2. The septic tank a distrl u Ion box shall be set Bottom of Test Hole 1 Elev.- 88.50 level on 6" of 3�41 d 1 ppl stone. _ CULTEC 3050 INFILTRATOR CHAMBER H-20 (OR EQUIVALENT) 3. Backfill should be clean sand or gravel with no ALL Groundwater Observed - NONE OBSERVED NOTE: OVERALL HEIGHT OF INFILTRATOR IS 30" EFFECTIVE HEIGHT IS 24" stones over 3" in size. PERCOLATION TEST as OUTLET"�'H°"'B 4. This system is subject to inspection during installation SET sox LILAS by Carmen E. Shay - Environmental Services, Inc. SET LEVEL FOR AT IEIST 2 R. 12' OONCRETE COVER ` •••• PROJECT BENCH MARK 5. The contractor shall install this system in accordance Date of Percolation Test: FEB. 24, 2010 'KKIMO7OUTLUI " ""' `'• with Title V of the Massachusetts state code, the approved plan Test Performed By. CARMEN E. SHAY,R.S., C.S.E. TOP OF FOUNDATION and Local Regulations. Results Witnessed By. DAVID STANTON'(BARNSTABLE BOH) - ''• 1z' �T ELEV. = 100.00 Assumed EXCAVATOR: SHAY ENVIRONMENTAL SERVICES, INC. e• TEST HOLE #1 6. If, during installation the contractor encounters any soil conditions or site conditions that are different Percolotion Rate: Less Than 2 MPI O 36" O TPtELEV.- 97.50 S 29D 28' 20"E from those shown on the soil log or in our design 4' - . 40 Te installation must halt dt immediate notification be Test Hole Test Hole "a• TEST HOLE2 137.00' made to Carmen E. Shay - Environmental Services, Inc.No. 1 No. 2 PLAN SECTION CROSS-SECTION ELEV.- 97.50 DEPTH SOILS ELEV. DEPTH SOILS ELEV. 14 b' , 98 7. No vehicle or heavy machinery shall drive over the - septic system unless noted as H-20 septic components. 0 97.50 0 97.50 3 HOLE H-10 DISTRIBUTION BOX 2v5' 6' 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. Sandy Sandy NOT TO SCALE 4" PVC S 4.�?r� r;'A;!• i.r„n! w i _fGiied ~' • Loam Loam {v %.e'><t' • t y�s. 9. All Distribution Lines shall be 4 diameter Schedule 40 NSF PVC pipes. VENT s A -1 - CESSP00 LOT #8 10. All solid piping, tees tat fittings shall be 4" diameter o"-s' to YR 3/2 A 97.00 0' 10 YR 3/z-6' A 97.00 ____ _________ uwv Feet 9 Failed 15,479 S + _ Schedule 40 NSF PVC pipes with water tight joints. Lind Sand 98 D-Box ~ CESSPOOL 11. Municipal Water is AVAILABLE to ALL OF The Residence and Abutting 10 YR a/e 10 YR 5/e O - • • Failed Properties Within 150 Feet. NO PRIVATE WELLS PRESENT W/IN 200' 6'-36' Be 4.50 6•_36• Be 94.50 1 Leach Pit THE PROPERTY LINES ARE APPROXIMATE AND Mod-Coarse se Me Sand nd eerss COMPILED FROM THE PLAN BY CHARLES SAVARY dt CO., ENTITLED PLAN OF LAND in HYANNIS MA Sand 4 �--________ 36"-132' C. 66.50 36•-132' C, 86,50 441 ,� _ DECK- _ DATED MARCH 8, 1968, PLAN BOOK 222 PAGE 31 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN - IT SHOULD BE USED FOR NO PURPOSE OTHER THAN LOT #9 / w �99 THE SEPTIC SYSTEM INSTALLATION. c� M C Concrete EXISTING g r� EXISTING CESSPOOLS do LEACH PITS TO BE PUMPED OUT AND 4 O Patio Y 4 BEDROOM Y: � LOT #7 REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION � w j HOUSE I � NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE 6 � FROM THE EXISTING CESSPOOLS AND LEACH PITS TO BE DISPOSED #76 I q OF AS PER BOARD OF HEALTH SPECIFICATIONS. Perc #1 Depth to Perc: 36' to 54 " / I i I I b THERE ARE NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY Perc Rate- <2 MPI Assumed 4 ��`-_ Groundwater Not Observed ASSESSORS MAP 250 LOT 056 No Observed ESHWT J I ADJUSTED H2O Elev. - None I I ---------- I I g _ _ o ASPHALT i J --99 104X1 DENOTES PROPOSED Design Calculations 9B, I »- Number of Bedrooms: 4 Equivalent to 440 Gal./Day SPOT GRADE DRIVEWAY i � o , Garbage Grinder. No I I I _--------------- _ __-98 Leaching Capacity Proposed: 440 Gcl./Day Minimum DENOTES EXISTING �,, - x 104.46 SPOT GRADE i Septic Tank _ - 2 x 440 Gal./Day - 880 USE NEW 1,500 GAL. Septic Tank. '�-� __--I----� � L - 54.1 BT SOIL ABSORPTION AREA: Using percolation rate of <2 min./Inch Bottom Area: 0.74 gal/sq. ft. x 432 sq. ft. - 319.68 gallons , i I R = 155.43' PL PROPERTY LINE 71.59 I i I 96P PROPOSED CONTOUR Sldewall Area: 0.74 gal./sq. ft. x 192 sq. ft. = 142.08 gallons N 29D 28' 20"W _L------------------------- ---------- Providing: - 461.76 gallons El r ; - - - - -- -97 EXISTING CONTOUR Use: (4) 3050 H-20 INFILTRATOR CHAMBERS, HAVING A 2' EFFECTIVE DEPTH, ____---_-_-__ (4' W x 7' L) TO BE USED WITH 4' OF WASHED STONE ON THE SIDES AND DEEP TEST HOLE & 4' OF WASHED STONE ON THE ENDS. PERCOLATION TEST LOCATION TYPICAL 1500 GALLON SEPTIC TANK VA NDERMINT LA2V-jE7 •-. 6 FOOT STOCKADE FENCE ( -- NOT TO SCALE 40 FOOT RIGHT OF WAY) 3-Z4• aAN. ACCESS MANHOLES (H-10 LOADING) - 10•-e• br;. • . �•.�y:� ,s:_ .;: Kitchen w Bedroom PLOT P LAN Dining m GARAGE OF SEPTIC SYSTEM UPGRADE INLET 1 `-1 l • INLETrt W THE ACCESS COVERS FOR THE SEPTIC TANK, Living Roo Bedroom PREPARED FOR DISTRIBUTION BOX AND LEACH �'' SHALL BE RAISED TO WITH N BIN OFCOMPONENT FINISHED GRADE. R 0 B E RTA REEVES •I'�'�Ta•v,:r+'z�'T"��T`- '" STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TITE GAS BAFFLES OR EQUALS 1 St Floor AT PLAN VIEW ON ALL OUTLET TEE ENDS 76 VA N D E R M I N T LANE �3_24•REMOVABLE COVERS� r• H YA N N I S , MA 02601 : • min. al Co O ,V^-� © -L'C� G�1 << .- MLLET a• min. r min. Het to outlet e'mY+ t3• INLET "-'50 t Lrr.� ouTu� - _�. --_ �.. o PREPARED BY: a _,• > - �e 4-0• min. ~5 _,• `� 0 Bedroom ' l�ARl rl li 1 Y Li . AS'HIl Y EP 1 b 3 e.ew, •" Llyuki depth „ , SCALE: 1 =20 m ENVIRONMENTAL SERVICES, INC. 111 THORNBERRY CIRCLE 101-0• a�•-e• LOCAL UPGRADE APPROVAL VARIANCE REQUESTED - MASHPEE, MA 02649 CROSS SECTION END-SEC ON { 2nd Floor ' TEL/FAX 508-539-7966 ` 1. REQUEST A LOCAL UPGRADE APPROVAL TOput SAS 1 4 BR 2 Story HOUSE-(Provided b SCALE: 1 "=20' DRAWN BY: CES DATE: MARCH 4, 2010 GREATER THAN 3 FEET BELOW GRADE, A VENT PIPE HAS BEEN PROVIDED. rY ( y Owner) PROJECT#SD1170 FILENAME: SD1170PP.DWG SHEET 1 OF 1